Clinical courses of five spontaneous spinal cord infarction cases

Abstract

  Spinal cord infarction (SCI) is a less frequent disease compared to ischemic cerebral infarction. We retrospectively reviewed the clinical courses, radiographical findings, and prognosis of five spontaneous spinal cord infarction cases in our single institution. We included four males and one female with a median age of 65.2 years old. Impaired spinal levels ranged from the upper thoracic to the upper lumbar spine. Only one case had a history of cardiovascular events. Their clinical symptoms were as follows: anterior spinal artery syndrome in three, posterior spinal syndrome in one, and Brown‒Séquard syndrome in one case. The mean time from onset to definitive diagnosis was 5.71 days. Among four patients who were treated by steroid pulse therapies with methylprednisolone, two patients showed neurological improvement after the treatment, while the other two patients remained unchanged. The functional outcomes were grade B in one case and grade D in four cases when evaluated by American Spinal Injury Association Impairment Scale classification. All patients were taken aspirin medication to prevent recurrence. In clinical practice, SCI is a rare but sometimes encountered disease. We report the clinical courses of five cases with a literature review.